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Developmental Milestones
Developmental milestones are important, measurable indicators of an individual's growth that are evaluated based upon age. Each milestone is associated with a specific age and indicates typical development, although the age at which a typically developing child reaches each of these milestones may vary considerably. The variability in the age that children reach these milestones results from the interaction between genetic and environmental factors. These developmental indicators are commonly used among infants and young children to assess their growth in a variety of areas. Examples of developmental milestones include children's first steps and words. Parents and professionals may observe these developmental areas to assess for delays, or reaching a milestone at a later-than-expected age. Delays in any area may affect future developmental capabilities, depending on the length and severity of the delay. If a delay is detected in any developmental area, professionals may search for the etiology and encourage early intervention.
| Table 1 Selected Developmental Milestones | ||||
|---|---|---|---|---|
| Ages | Domains | |||
| Physical | Cognitive | Language | Social | |
| Birth-2 months | Lifts head for short | Repeated motor | Cries | Responds to smile with |
| period | movements | Gurgles | smile or vocalization | |
| Hands remain in fists | Visually explores objects | Coos (vowel sounds) | ||
| Grasp reflex evident | in environment | |||
| Kicks legs and flings | ||||
| out arms | ||||
| 2–4 months | Rolls from side | Follows objects with eyes | Coos more frequently | Smiles at others |
| to side | Looks around | Vocalizes to make noise | (social smile) | |
| Lifts head | Responds to environment | Laughs aloud | ||
| Begins reaching for | (open mouth for nipple) | Makes brief eye contact | ||
| objects | ||||
| Grasps objects | ||||
| 4–6 months | Rolls from back to side | Attention becomes | Squeals | Vocalizes |
| Places fingers in mouth | flexible and changes | Babbles (vowel/ | to get attention | |
| First teeth emerge | Turns toward sources | Consonant combinations) | Joint attention with | |
| Sits with support | of noise | Repeats syllables | parents to label objects | |
| Grasps and shakes | Imitates sounds | |||
| objects | ||||
| 6–9 months | Crawls | Looks toward objects | Babbles 2 syllables | Stranger anxiety (fear |
| Pulls self up to stand | when named | (mama) | of unfamiliar people) | |
| with support | Awareness of objects | Creates nonsense | Expresses anger more | |
| Sits without support | only if in sight | syllables | frequently | |
| Moves objects from | Responds to name | |||
| hand to hand | ||||
| 9–12 months | Steps with support | Solves sensorimotor | Speaks first words | Points to objects for |
| Pincer grasp | problems by using | Uses gestures to | others to look at | |
| Stands alone | similar situations | influence others' | Laughs aloud | |
| Walks with support | from the past | behavior (point) | Imitates actions and | |
| (holding furniture) | Follows 1-word | Uses nonverbal | facial expressions of | |
| Coordination between | directions | communication | others Responds when | |
| two hands | Acquires object | signals (waves bye-bye) | adult's mood changes | |
| Feeds self using fingers | permanence (searches | Understands meaning | ||
| for objects that are not | of no | |||
| in sight) | ||||
| 12–18 months | Walks without support | Finds objects hidden in | Speaks several words- | Engages in turn- |
| Turns pages of a book | several places | often nouns | taking games | |
| Scribbles | Categorizes objects | Uses up to 20 words | (peek-a-boo) | |
| Crawls up and down | Attention improves | Shakes head to | Joins in play with | |
| stairs | Delayed imitation | indicate “no” | familiar people | |
| Asks for “more” | Signs of empathy | |||
| Copies unfamiliar sounds | apparent | |||
| Imitates adults | ||||
| 18–24 months | Runs | Follows simple directions | Speaks 2-word | Parallel play (plays next |
| Climbs | Identifies own body parts | combinations | to a peer) | |
| Jumps in place | Begins make-believe play | Uses 50–200 words | Self-control appears | |
| Kicks | Says own name | Recognizes emotions | ||
| Pulls and pushes | in others | |||
| objects | ||||
| 2–3 years | Fine motor skills | Plays with toys | Uses 3-word phrases | Demonstrates empathy |
| improve drastically | functionally (uses for | Names body parts | Difficulty sharing | |
| Begins to draw | intended purpose) | Uses up to 500 words | Takes turns in games | |
| Feeds self with utensils | Plays make believe | Asks simple questions | ||
| Alternates feet on stairs | ||||
| 3–4 years | Reaches bladder & | Uses color and shape | Uses 4- to 5-word | Cooperatively plays |
| bowel control | to sort objects | sentences | with other children | |
| Hops | Uses mechanical toys | Uses up to 1000 words | Prefers to play with | |
| Skips | Understands the | Says name and age | other children | |
| concept of two | ||||
| 4–5 years | Throws ball overhead | Names colors | Uses 4- to 7-word | Understands gender |
| Uses scissors | Recalls story segments | sentences | constancy | |
| Copies shapes | Understands | Tells stories | Plays creatively | |
| same/different concept | Understands basic | Seeks independence | ||
| grammatical rules | ||||
| 5–6 years | Hand dominance | Counts to 10 or higher | Uses 5- to 8-word | Wants to be similar to |
| apparent | Names several colors | sentences | friends | |
| Prints letters | Asks meaning of words | Likes to dance and sing | ||
| Catches a ball | ||||
| appropriately | ||||
Although development is frequently viewed holistically, developmental milestones are often applied to specific domains of development. Some of the most prominent areas in which development is assessed include the physical, cognitive, language, and social domains. Physical development entails all physical growth that changes a child's body, and includes such things as coordination and motor skills. Cognitive development refers to mental processes and includes memory and the ability to learn, among others. Language growth encompasses language acquisition and development and includes babbling and baby talk, as well as more advanced expressive language skills. Social development consists of social indicators that demonstrate adjustment to the social environment and includes emotion and interactions with others.
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